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Insight in schizophrenia–course and predictors during the acute treatment phase of patients suffering from a schizophrenia spectrum disorder

Published online by Cambridge University Press:  28 April 2012

R. Schennach ,
S. Meyer ,
F. Seemüller ,
M. Jäger ,
M. Schmauss ,
G. Laux ,
H. Pfeiffer ,
D. Naber ,
L.G. Schmidt  and
W. Gaebel
...Show all authors
R. Schennach*
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336Munich, Germany
S. Meyer
Affiliation:
Psychiatric Clinic, District Hospital, Augsburg, Germany
F. Seemüller
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336Munich, Germany
M. Jäger
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336Munich, Germany
M. Schmauss
Affiliation:
Psychiatric Clinic, District Hospital, Augsburg, Germany
G. Laux
Affiliation:
Psychiatric Clinic, District Hospital Gabersee, Wasserburg/Inn, Germany
H. Pfeiffer
Affiliation:
Psychiatric Clinic, District Hospital, Haar, Germany
D. Naber
Affiliation:
Department of Psychiatry, University of Hamburg, Hamburg, Germany
L.G. Schmidt
Affiliation:
Department of Psychiatry, University of Mainz, Mainz, Germany
W. Gaebel
Affiliation:
Department of Psychiatry, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
J. Klosterkötter
Affiliation:
Department of Psychiatry, University of Cologne, Cologne, Germany
I. Heuser
Affiliation:
Department of Psychiatry, Charite Berlin, Campus Benjamin, Germany
W. Maier
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany
M.R. Lemke
Affiliation:
Department of Psychiatry, Alsterdorf Hospital, Hamburg, Germany
E. Rüther
Affiliation:
Department of Psychiatry, University of Göttingen, Göttingen, Germany
S. Klingberg
Affiliation:
Department of Psychiatry, University of Tübingen, Tübingen, Germany
M. Gastpar
Affiliation:
Department of Psychiatry, University of Essen, Essen, Germany
H.-J. Möller
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336Munich, Germany
M. Riedel
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336Munich, Germany Psychiatric Clinic, Vinzenz-von-Paul-Hospital, Rottweil, Germany
*
*Corresponding author. Tel.: +49 89 5160 5511; fax: +49 89 5160 5728. E-mail address:Rebecca.Schennach@med.uni-muenchen.de (R. Schennach).
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Abstract

Background

To analyse insight of illness during the course of inpatient treatment, and to identify influencing factors and predictors of insight.

Methods

Insight into illness was examined in 399 patients using the item G12 of the Positive and Negative Syndrome Scale (“lack of insight and judgement”). Ratings of the PANSS, HAMD, UKU, GAF, SOFAS, SWN-K and Kemp's compliance scale were performed and examined regarding their potential association with insight. The item G12 was kept as an ordinal variable to compare insight between subgroups of patients.

Results

Almost 70% of patients had deficits in their insight into illness at admission. A significant improvement of impairments of insight during the treatment (p<0.0001) was observed. At admission more severe positive and negative symptoms, worse functioning and worse adherence were significantly associated with poorer insight. Less depressive symptoms (p = 0.0004), less suicidality (p = 0.0218), suffering from multiple illness-episodes (p<0.0001) and worse adherence (p = 0.0012) at admission were identified to be significant predictors of poor insight at discharge.

Conclusion

The revealed predictors might function as treatment targets in order to improve insight and with it outcome of schizophrenia.

Keywords

InsightSchizophreniaCoursePredictorsOutcome
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 8 , November 2012 , pp. 625 - 633
Copyright
Copyright © European Psychiatric Association 2012

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